title: A double-blind placebo-controlled randomized trial on probiotics in small bowel bacterial overgrowth in children treated with omeprazole.
abstract: OBJECTIVE
  To evaluate the incidence of small bowel bacterial overgrowth (SBBO) in children treated with omeprazole, and to test whether probiotics influence the incidence.
  
  
  METHODS
  A double-blinded, placebo-controlled trial was performed in 70 children treated orally during four weeks with 20mg omeprazole per day. Lactobacillus rhamnosus R0011 (1.9×10(9) cfu) and Lactobacillus acidophilus R0052 (0.1×10(9) cfu) were simultaneously given daily to 36 subjects (probiotic group), while 34 subjects received placebo (placebo group). The diagnosis of SBBO was based on the development of suggestive symptoms, in combination with a positive glucose breath test.
  
  
  RESULTS
  After one month of proton pump inhibitor (PPI) treatment, 30% (21/70) had a positive breath test suggesting SBBO; of these 62% were symptomatic. Five children developed SBBO-like symptoms, but had a negative breath test; and 44 (63%) were symptom free and had a negative breath test. There was no difference in the incidence of positive breath tests in the probiotic versus the placebo group (33% vs 26.5%; p=0.13).
  
  
  CONCLUSIONS
  Since symptoms suggesting SBBO developed in 26% of PPI-treated children, and since the glucose breath test was abnormal in 72% of these, this side-effect should be more frequently considered. The probiotic tested did not decrease the risk to develop SBBO.
authors.affiliation: Department of Child Health, University of Indonesia, Dopok, Indonesia.
authors.forename: Badriul
authors.initials: B
authors.lastname: Hegar
authors.forename: Esther I
authors.initials: EI
authors.lastname: Hutapea
authors.forename: Najid
authors.initials: N
authors.lastname: Advani
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
mesh_terms: D000293:Adolescent; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000382:microbiology; D004311:Double-Blind Method; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D006801:Humans; D007421:Intestine, Small / Q000187:drug effects / Q000382:microbiology*; D007779:Lactobacillus acidophilus; D052201:Lacticaseibacillus rhamnosus; D008297:Male; D009853:Omeprazole / Q000008:administration & dosage / Q000009:adverse effects*; D010919:Placebos; D019936:Probiotics / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010919:Placebos; D054328:Proton Pump Inhibitors; D009853:Omeprazole
keywords: (Hydrogen) breath test; Diarreia; Diarrhea; Flatulence; Flatulência; Inibidor da bomba de prótons; Omeprazol; Omeprazole; Probiotic; Probiótico; Proton pump inhibitor; Small bowel bacterial overgrowth; Supercrescimento bacteriano do intestino delgado; Teste de hidrogênio no ar expirado